Change Request Detail
No.
1122
Date
1/27/2011
Submitter
Type of Request
Dental Claim
Status
DSMO Process Completed
Business Reason
Provider Taxonomy in Pay-To Provider is used for provider matching process.  Some providers bill under multiple specialties.
Suggestion
Allow Taxonomy codes to be submitted in loop 2000A PRV segment for Pay-to Provider. (PRV01 = PI, PRV03 = Taxonomy Code)
DSMO Category
D
Recommendation
Disapprove. The Pay-To Provider is not a separate entity.
Appeal Recommendation